The practice by insurance companies of hiring doctors to review disability benefit claim files has been coming under increasing fire.Doctors are hired to assess a claimant’s disability based on a review of records rather than examining the claimant or even speaking with the claimant or the treating doctors.A recent ruling from Tennessee, Carty v. Metro. […]
The Employee Benefits Security Administration of the U.S. Department of Labor has issued final regulations published in the Federal Register on December 19, 2016 (81 Fed. Reg. 92316) relating to disability benefit claims governed by ERISA.Proposed regulations were initially published for comment on November 18, 2015 at 80 Fed.Reg. 72014; and after considering over 100 […]
You have likely heard of the Employee Retirement Income Security Act (ERISA) that establishes minimum standards for pension plans in private industry. But, do you know anything about the agency that manages it? To best understand ERISA, it is important to know the history and structure of the agency that manages it. Pensions have a […]
Doctors must maintain neutrality in disability claims, but conflicts of interest can arise due to their relationships with insurers.
The interaction between pre-emption and discretion can make ERISA cases more complex, and require expert legal assistance.
It is not uncommon to find provisions in disability and accidental death insurance policies that exclude coverage in situations where alcohol or drug ingestion causes the injury or death. It is not enough, though, to merely show the insured was intoxicated. According to cases such as Holloway v. J.C. Penney Life Insurance Co., 190 F.3d […]